Case 51 -- Acute Renal Failure

PATIENT HISTORY :
The patient is a 73 year old white man with a history of
hypertension and benign prostatic hyperplasia, who presents with
a three month history of fever, malaise, anorexia, twenty-five
pound weight loss, diffuse myalgias and night sweats, and most recently hemoptysis.
His baseline creatinine at the time of admission was 1.9 mg%.
Medications on admission included Hytrin, Digoxin, Lasix, Pepcid
and Bactrim. He was also receiving steroids at an
unspecified dose.

Review of systems at the time of admission was
positive for hypertension (200/100) and microscopic
hematuria. There was no evidence of edema, gross hematuria,
flank pain, history of stones, dysuria, oliguria, anuria,
nephrotic syndrome, polyuria, renal masses, family history of
renal disease and diabetes.